2-micron Continuous Wave Laser Assisted Neuroendoscopy: Clinical Experience of Two Institutions in 524 Procedures.
World Neurosurg. 2018 Sep 20;:
Authors: Schuhmann MU, Kural C, Lalla L, Ebner FH, Bock C, Ludwig HC
OBJECTIVE: The aim of this study is to present the clinical experience of two neurosurgical centers with the use of a 2-micron continuous wave laser (2μ-cwL) system as standard tool in neuroendoscopic procedures and to discuss the safety and efficacy of this system.
METHODS: 469 patients underwent neuroendoscopic procedures using 2μ-cwL between September 2009 and January 2015. All patient data were retrospectively reviewed. 241 (51%) patients were children and 228 (49%) adults. Mean age was 27.5 years (range:3 days - 83 years). Intraoperative ultrasound
or neuronavigation iwere used to guide ventricular or cyst puncture and for intraventricular or intracystic orientation if necessary.
RESULTS: A total of 524 neuroendoscopic procedures using 2μ-cwL were performed. Laser-assisted endoscopic third ventriculostomy (LA-ETV) was the most common procedure in 302 (64%) patients. Cyst fenestration was performed in 124 (26%), septostomy in 45, tumor biopsy in 41, tumor resection in 8 and choroid plexus coagulation in 3 patients. There was no intra-operative complication directly attributable to the use of laser and an overall procedural complication rate of 4.8%.
CONCLUSION: This large series of 2μ-cwL as a routine tool in neuroendoscopic procedures demonstrates, that this 2μ-cwL is safe for ETV, septostomy, cyst fenestration and intraventricular tumor biopsy or resection. As a cutting and coagulation tool it combines the action of mechanical tools like forceps, balloons and scissors plus those of electric tools. It therefore renders neuroendoscopic procedures more straightforward with a minimum need to change tools.
PMID: 30244186 [PubMed - as supplied by publisher]